Exam #2 Mental Health Flashcards PDF

11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt Exam #2 Mental Health abuse, violence against parent, mental illness, What are some examples of ACES?...

11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt Exam #2 Mental Health abuse, violence against parent, mental illness, What are some examples of ACES? incarceration, substance use Physical response to stress (increase HR,BP, RR, Fight or flight and CO) Alarm: inital physical response to prepare for threat Resistance: Optimum resistance against stressor Describe the GAS (usually when it is over come) Exhaustion: if threat is not overcome resources are depleted stress becomes chronic Sleep (>7 hrs) Excercise (20min/day or 150/wk); excercise 3 hrs before bed Reduction of caffiene intake (No What are some “stress busters”? more than 4 cups of coffee/cola) Music (listen to familar songs) Pets Massage Idea that by observing physical reactions to Biofeedback stress you can learn to control them focus on taking deep abd breaths hold for 3 Deep-breathing excercises secs then exhaling through mouth (repeat for 2- 3 min) Pt taught to focus on pleasant images to Guided imagery replace negative feelings https://knowt.com/flashcards/7496efbf-f6c2-4970-91a6-920b66efab09?isNew=true 1/20 11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt Progessive relaxation Tensing and relaxing muscle groups Training brain to develop calm by focusing on Meditation object, thought, or sound Mindfulness Being aware of surroundings using senses Cognitive Reframing Evaluating and replacing irrational thoughts perception is heightened; Describe Mild anxiety focus is flexible can problem solve discomfort attention-seeking restlessness S/s of mild anxiety easily startled irriable/impatient tension relieving behaviors (chewing lip, fidgeting, finger tapping) Narrowed perception Describe Moderate anxiety Less focused; concentrated on source of anxiety Able to problem solve but less than optimal S/S of moderate anxiety voice tremors/ change in pitch poor concentration shakiness somatic complaints (headache, body ache, urinary frequency) https://knowt.com/flashcards/7496efbf-f6c2-4970-91a6-920b66efab09?isNew=true 2/20 11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt More tension-relieving behavior (banging hands on table, pacing) Perception is reduced and distorted focuseds on specific detail or is scattered Describe severe anxiety unabcle to problem solve, cannot see connections between events dread/impending doom confusion purposeless activity more somatic complaints (chest discomfort nausea) S/S of severe anxiety sweating withdrawn loud/rapid speech threats/demands Unable to attend to environment focus is lost (depersonalizaton/derealization) Describe panic level anxiety completely unable to process reality (irrational/disorganized) s/s of panic terror immobility/hyperactive/flight inability to speak https://knowt.com/flashcards/7496efbf-f6c2-4970-91a6-920b66efab09?isNew=true 3/20 11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt somatic complaints (numbness, tingling, SOB, overheated, palpation) severe withdrawl hallucination/delusions out of touch with reality Have pt identify anxiety focus on clients’ concerns Interventions for pt with mild-moderate anxiety Encourage problem-solving Explore previously helpful coping mechanisms Provide an outlet for working off excess energy STAY WITH PT AT ALL TIMES Maintain calm manner Decrease environmental stimuli Interventions for pt that is experiencing severe - Attend to physical and safety needs (provide panic levels of anxiety outlet for energy) Set physical limits using firm voice adn authoritative voice Constant movement = high calorie fluid unconsious transformation of anxiety into Conversion physical symptoms Disruption in consciousness resulting in Dissociation compartmentilization Identification Attributing aspects of another onto ones self Intellectualization Analysis of situation using only cold hard facts https://knowt.com/flashcards/7496efbf-f6c2-4970-91a6-920b66efab09?isNew=true 4/20 11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt Justifying illogical/unreasonable ideas by Rationization developing satisfying explanations Projection Is always immature, no adaptive use unnacceptable behaviors/ feelings controlled Reaction Formation via the development of opposite feeling/behavior unconscious exlusion of unpleasant of Repression unwanted experience inability to integrate postive and negative Splitting qualities of others of self, ALWAYS maladaptive Unconcious process of transforming negative Sublimination impulses into postive one, always adaptive conscious delay of addressing disturbing Supression situation and or feeling Person makes up for regrettbale act or Undoing communication Developmentally inappropriate levels of Separation Anxiety concern over being away from a significant relationship (usually diagnosed before 18 yrs) Irrational fear of a specific object, activity, or situation that leads to avoidance or actual Phobia avoidance of the object, activity, or situation that interfere with function Severe anxiety or fear provoked by exposure to Social Anxiety Disorder a social or performance situation that could be evaluated negatively by others sudden onset of extreme apprehension assosiated with impending doom Panic Disorder s/s feel like theyre have a MI or losing their minds “fear the fear” https://knowt.com/flashcards/7496efbf-f6c2-4970-91a6-920b66efab09?isNew=true 5/20 11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt Hyperventilating? Deep breath technique Help pt realize physcial s/s are from anxiety (not What are some intervention for a person with health problem) Panic disorder Teach abd breathing and to use ASAP when anxiety is recognized intense and excessive anxiety about being in Agoraphobia places from which escape might be difficult or embarrassing eccessive worry out of proportion of the true impact of events or situations Generalized Anxiety Disorder s/s feeling inadequate, putting things off, need for continual reassurance Speak slowly, and calmly assure pt you are into control Interventions for pt with GAD help pt reframe events postively decrease stimulation Antianxiety consideration: SSRIs may increase anxiety at first SSRIs, SNRIs, benzos, buspar, antihistamine, What are some drugs used for antianxiety? gabapentin What kind of drugs are used for GAD SSRI, SNRI, Benzos, buspar What medications are used for panic disorder SSRI, SNRI, Benzo What medications are used for SAD ? SSRIs, SNRIs Behavioral: modelling, flooding, thought What psychological therapies are used for stopping, systemic desenitization anxiety CBT https://knowt.com/flashcards/7496efbf-f6c2-4970-91a6-920b66efab09?isNew=true 6/20 11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt thoughts, impulses, or images that persist and Define obsessions reoccur even when person tries to dismiss them ritualistic behaviors individuals feel driven to Compulsion: perform to reduce anxiety religious/lossing control harm unwanted sexual thoughts perfectionism Types of obsessions/compulsions violence contamination superstitions a. presence of obsessions and/or compulsions What is the DSM criteria for OCD b. obsessions/compulsions are time consuming (>1 hr / day) or cause significant distress Body dysmorphia (focused on “defective” body part) Hoarding What are different types of OCD? Trichotillomania (hair pulling) Excoriation (skin picking) All improvements should be recognized and What is important for pts with OCD? affirmed Realistic Perception In a crisis what chracteristic impact outcome Support system Adequate coping mechanism Seven stages of Crisis Intervention 1. Crisis assessment (lethality) 2. est rapport (quickly est relationship) 3. identify major problems https://knowt.com/flashcards/7496efbf-f6c2-4970-91a6-920b66efab09?isNew=true 7/20 11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt 4. deal with feelings 5. generate alternative solutions 6. develop action plan (resolution) 7. Follow up plan and appointment Maturational crisis occurs during developmental stages Situational crisis occurs because of unexpected distressing event Adventitious crisis Crisis from traumatic external event #1 safety #2 perception of events Assessment of person in crisis #3 assess support #4 assess coping skills 1. mitigation (limit disasters impact) 2. preparedness (develop preparedness plan) 3. response (occurs in the immediate aftermath of event includes evacuation What are the 4 phases of crisis response and search and rescue) 4. recovery (restoration occurs along with normal functioning activities of the community) What are some treatment modalities for crisis? Crisis Call Lines : first line support acute crisis Warm Lines: prevents escalation of distress into crisis Crisis intervention teams: teams available to reach any person where they are https://knowt.com/flashcards/7496efbf-f6c2-4970-91a6-920b66efab09?isNew=true 8/20 11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt Crisis stabilization facilities: provides short-term care (24 hrs) to quickly de-escalate crisis situation Suicidal behavior disorder a suicide attempt within the last 24 months increased drug and alcohol use withdrawn from community/family reckless/risky behavior What are some warning signs of suicide dramatic mood changes talking about feeling trapped previous attempt family hx of suicide access to lethal means anxiety Risk factors for suicide attempt losses chronic conditions psychosis substance use disorder access to mental health care strong connections Protective factors against suicide marriage/children problem solving skills contact with providers 1. Current risk 2. Assess for plan Assessment of suicidal patient 3. Hx of behaviors https://knowt.com/flashcards/7496efbf-f6c2-4970-91a6-920b66efab09?isNew=true 9/20 11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt Determines how quickly a person would die from method. High Risk (“hard methods”) = gun, car crash, Explain lethality carbon monoxide, hanging, jumping off high place Low risk (“Soft methods”) = cutting wrist, natural gas, ingesting pills If you suspect suicidal ideation you should? Ask patient if they are suicidal Few days after admission and during shift When is suicide risk highest for patients? change Warning signs for suicide attempt Coping strategies What should be included in safety plan? Support people Identifies things in life worth living for plastic utensils (count after tray is returned) not assigned to private room, door always open all doors locked What are some environmental guidelines for go through person belongings with pt suicidal pt and remove hazardous items search gifts and items brought by visitors search pt if allowed to leave facility via pass mental healthcare for suicide survivors (circle of What is a post-vention? people survivors who knew the person who commited suicide) https://knowt.com/flashcards/7496efbf-f6c2-4970-91a6-920b66efab09?isNew=true 10/20 11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt focus on the survivor not the person that attempted hardest times are years and months after death How should nurse treat suicide survivors? speak of the deceased often recommend community resources have friends and family check up on each other 5 days within last year of self inflicted damage What is the diagnosis for nonsuicidal self injury? without suicidal intent Delusions that lasted a month or longer; What is delusional disorder ? doesn’t impair function sudden onset of at least one of the following (lasts longer than a week but shorter 1 month): delusions What is brief psychotic disorder? hallucinations disorganized speech catatonic behavior exactly like schizophreia that lasts less than 6 Schizophreniform d/o months MDD, manic, or mixed episode involving Schizoaffective d/o schizofrenic symptoms Males : 15 - 25 yrs When is the normal onset Females: 25 - 35 yrs What are the stages of schizophrenia? Prodromal: before acute symptoms, mild changes in mood (appears 1 - 12 mo before onset) https://knowt.com/flashcards/7496efbf-f6c2-4970-91a6-920b66efab09?isNew=true 11/20 11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt Acute: symptoms become apparent, usually occurs after stressful events Stabilization: s/s are stabilizing and diminishing Maintenance: condition has stabilized positive symptoms are diminished, negative signs might still be a concern Changes in reality testing Delusions Positive signs of schizophrenia include Hallucinations Alterations in speech Alterations in behavior believing one is being singled out for harm or Persectory delusions are prevented from making progress belief that events/circumstances are somehow Referential delusion is related to you Erotomanic Believing that another person desires you nihilistic delusion conviction that a major catastrophe will occur somatic delusion belief that body is changing in unusual way believing that another external force control control delusion thoughts, feelings, impulses, or behavior repetitive behaviors that do not serve a logical Stereotyped behavior purpose impaired ability to identify where ones body or boundary impairment influlence ends and another begins What are negative signs of schizophrenia? absense of essiential human qualities Define avolition reduction in motivated or goal-direct behavior Alogia reduction is speech (poverty of speech) https://knowt.com/flashcards/7496efbf-f6c2-4970-91a6-920b66efab09?isNew=true 12/20 11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt is a cognitive symptom that results in an Anosognosia inability to realize one is ill 2 or more of the following for a significant portion of 1 month: (one has to be from the first three) delusions What is the diagnostic criteria for schizophrenia hallucinations disorganized speech grossly disorganized or catatonic behvaior negative symptoms poor hygience, resistant to care, cheeking/palming their meds, anosognosia, What are some issues you may face when a pt depression, poor self esteem, fall risk, choking is experiencing psychosis risk, restlessness, risk for violence towards self or others Avoid refering to hallucinations as if they are real do not negate experience but offer your POV Interventions for person experiencing address the underlying emotions and hallucinations themes promote reality testing guide pt to see that hallucinations are s/s of illness Teach pt experiencing hallucination manage stress if auditory use other sound to drown out noise promote reality testing distract yourself from hallucinations https://knowt.com/flashcards/7496efbf-f6c2-4970-91a6-920b66efab09?isNew=true 13/20 11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt talk to yourself or to hallucination (tell it to go away) Make contact with others Develop plan on how to cope build trust respond to suspicion with calm, matter-of-fact manner never debate How can nurses help pts who are experiencing as reality testing improves convey delusions doubt validate if part of delusion was real focus on feelings refocus on reality based topics never pretend to understand what patient is saying place difficulty of understanding on Interventions for associative looseness self look for recurring issues speak concisely dry mouth, urinary retention, constipation, What are some side effects of anti psychotics blurred vision, dry eyes, sexual dysfunction, tachycardia, cholestatic jaundice hot, dry skin bowel obstruction What are signs and symptoms of mydriasis anticholinergic toxicity? unstable v/s urinary retention https://knowt.com/flashcards/7496efbf-f6c2-4970-91a6-920b66efab09?isNew=true 14/20 11/10/24, 12:59 PM Exam #2 Mental Health Flashcards | Knowt physostignmine, cooling measures PRN, and How do you treat anticholinergic toxicity hold all medications How do you treat pseudoparkinsonism? trihexyphenidyl or benzotropine Admin trihexyphenidyl, benzotropine, or How do you treat dystonia? benadryl IM Propanolol, lorazepam, diazepam, How do you treat akatheisia trihexyphenidyl, benzotropine how do you treat tardive dyskinesia Valbenazine and deutetrabenzine monitor pts ANC weekly for 6 mo then twice a Explain what I need to know about severe month for 6 mo, then monthly neutopenia Severe =